Hancock’s half-app is a licence to kill the GP services we rely on

Health Secretary Matt Hancock is taking over where his woeful predecessors Jeremy Hunt and Andrew Lansley left off by escalating the Tories assault on the NHS as a public, comprehensive service – and is doing so, as they did, by stealth-privatisation.

Hancock was due to announce today – and tweeted to confirm it – Tory ‘plans to help people take responsibility for staying healthy‘:

This amounts to little more than a plan to push even more of our health service into the hands of corporations, as health campaigner Steven Carne quickly observed:

And it’s a one-way plan – designed to kill off local GP services to ensure that a future Labour government can’t undo this wanton privatisation.

Half-measures

The Tories’ ‘GP at Hand’ digital service provides basic GP services for those who sign up to it. But those who do sign up mustderegisterfrom their existing, local GP service. This means that the funds that the local GP practice would receive for having each patient on their books is lost – withering the practice as it loses more and more of its funding.

However, as GP and health campaigner Dr Kailash Chand pointed out, it does not offer services equivalent to those of a traditional, physical GP practice:

Babylon [the provider of GP at Hand] is happy to provide its services to anyone. Except it advises a woman who is, or may be, pregnant that it might not be suitable for their needs; nor for someone with complex mental health conditions; nor for a person with complex physical, psychological and social needs. And those with dementia or other old age conditions related to frailty or end-of-care needs are gently reminded they might need a GP closer to home.

In other words, while the digital service will fullyde-fund the local GP practice of the cash it would receive for having a patient on its books, it only provides a partial replacement digitally.

Those who have expensive, profit-killing, complex needs – from expectant mothers to people with Alzheimers – are left looking for a full-service GP that will not exist locally, if the planned digital roll-out ‘succeeds’.

This is a con-trick by the Tories, not an accident. The atrophy of local GP services is policy, not a side-effect – part of NHS boss Simon Stevens’ ‘Five year forward view’.

A campaigner with experience of the bankruptcy-machine that is US health described the plan to the SKWAWKBOX as being ‘a backward step even in the US‘ and continued:

There’s a cultural aspect to it. They are training people not to access direct care.

SKWAWKBOX comment:

The Tories will not, of course, announce with fanfare, “Hey, great news – we’re going to starve your local NHS services until they can’t be revived so we can privatise what you rely on every day as well as your hospitals. And we’re going to do it in a way that means they’re impossible to get back!”

But that’s exactlywhat they’re doing – under cover of making us all ‘take responsibility’ for becoming ill and steering us all toward online doctors instead of local ones.

All this goes alongside recent decisions to deny IVF treatment to those over 34 years of age and to deny routine surgery to smokers and patients with a body-mass index over 27 as evidence of the Tories’ relentless, ideological assault on our nation’s greatest achievement.

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13 comments

This sounds like yet another toerag venture into IT that will be a complete f’ing waste of time and money.

Skwawkbox tells us what’s likely to happen – IF it succeeds.

And that’s an enormous ‘IF’

Those (fools) who DO sign up are gonna be the ones needing to worry whether the actual thing works – And given the record of Govt IT it’s extremely doubtful, and unlikely to function 100% after all the tweaks it’ll inevitably receive.

But when all’s said & done, the answer is NOT to sign up to it. I won’t be doing so. Millions of people (especially the elderly) without access to the internet won’t, neither.

A new service using Babylon technology was launched in November 2017 in London. It claimed that patients could ‘book an appointment within seconds’ via its smartphone app and have ‘a video consultation with an NHS GP typically in under two hours of booking, anytime, anywhere’. The advertising was ruled misleading by the Advertising Standards Authority in October 2018 because it did not make it clear that users would first have to leave their GP, and registration could take up to three weeks. Nor did it state that potential users must live within 40 minutes of one of five surgery catchment areas in London in order to see a GP in person.

Patients are registered with the practice, GP at hand partnership, online via the website – and deregistered from their existing general practice. It was criticised as promoting “inequitable access to NHS-branded GP services.” by the British Medical Association. The practice defended itself by pointing out that payments were made under the standard GP contract: “Global sum makes up the bulk of payments to practices, and allocates funding in accordance with the Carr-Hill formula. This formula takes into consideration, along with other practice characteristics, individual patients’ age, gender and health conditions and calculates a “weighted” count of patients according to need.”

A list of patients advised not to register with the service was published:

Women who are or may be pregnant
Adults with a safeguarding need
People living with complex mental health conditions
People with complex physical, psychological and social needs
People living with dementia
Older people with conditions related to frailty
People requiring end of life care
Parents of children who are on the ‘Child at risk’ protection register
People with learning difficulties
People with drug dependence

Robert Plomin FBA is a world-renowned genetic psychologist who just happened to be interviewed on BBC Hard Talk recently.

He confirmed that, after a lifetime’s work on separated-at-birth twins and the nature vs. nurture conundrum, nurture’s effect on health outcomes was (statistically I think) insignificant compared to inherited genes.

In other words, a person’s lifetime health owes almost nothing to that person’s life choices and actions – conclusive proof that the over-promoted back-bencher Hancock is full of shit.
Not his fault of course – genes being genes.

As with health, educational and life achievement potential is also determined by genes – with the single exception he neglected to mention which is the British Public Schools system’s old boy network.

ps. Tories are unlikely ever to concede genetic inheritance’s part in our life chances – the criminal justice system and capitalism couldn’t co-exist if outcomes were dependent on our luck in the genetic lottery.

Florence, however galling it might be, science is science.
The physical, intellectual, social, historic or financial ability to dominate only confers the right to do so in a capitalist, every-man-for-himself society – changing that is what socialism is all about, surely?
Society needs a wide gene pool, not least because survival of the species in the face of some future plague may depend on specific genetic factors, as sickle cell protects against malaria.
We may not always be able to invent drugs for everything.

Florence, I forgot to refer back to the public school factor – private education, private tuition, hothousing, exam papers made available and ‘cash for essays’ – Google it – give the children of the rich what might charitably be described as ‘a bit of help’ with exams and these are not the only advantages our Tory MPs and masters had.

Apparently less predictive of health outcomes than genes or than we’ve been led to believe according to Prof. Plomin, although I don’t believe he would have intended to exclude all possibility of self harm.
As far as self-inflicted harm and the witholding of treatment by the state is concerned, one shouldn’t imagine that rationing would stop at your examples, given a Tory government.